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HomeMy WebLinkAbout03-15-11 (2)INVENTORY ~ ~:__ REGISTER OF WILLS OF CUMBERLAND COUNTY, PEIYLVAIStIA =a, ~~D ~, , ' ,~, - r- r__. - j l COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF Cumberland } SS File Number 21-10-00717 .. y c~j ~~ ~ -; ::z~ ,: Jon L. Shedlosky --~ __.~ == --- - - ~ -r Personal Representative(s) of the Estate of Evelyn B. Shedlosky ~ _, ~-''' O ., a deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent at he valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, d th Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memo nd at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- Jon L. Shedlosky ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Attorney -- (Name) (Finn) (Address) (Telephone) Michael L. Ban (Supreme Court L i~. No.) 41263 429 South 18th Street, Camp Hill, PA 17011 717/730-7310 __ DATE OF DEATH LAST RESIDENCE 22O Garrett Lane DECEDENT'S SOC. SEC. NO. 06/20/2010 Cam Hill PA 17011 191-18-3748 FIGURES MUST BE TOTALED Personal Property Cash ............................................................................................... Personal Property ........................................................................ Stocks/Listed ................................................................................ Stocks/Closely Held ..................................................................... Bonds ............................................................................................ Partnerships and Sole Proprietorships ..................................... Mortgages and Notes Receivable ............................................... All Other Property ........................................................................ Total Personal Property ........................................ Total Real Property ................................................ Total Personal and Real Property ........................ 1,376.36 3,172.40 4,548.76 280,000.00 284,548.76 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S. § 3301(b)) Form 14W-09 Rev. 10-13-2006 INVENTORY REGISTER OF WILLS OF CUMBERLAND COMMONWEALTH OF PENNSYLVANIA } SS couNTY OF Cumberland } DATE OF DEATH LAST RESIDENCE 220 Garrett Lane ~b DECEDENT'S SOC. SEC. NO. 191-18-3748 PSI Distribution Refund from Country Meadows Refund of premium from PDAIS Windstream dividend Windstream Dividend - (October 2010) Total Cash COUNTY, PENNSYLVANIA File Number 21-10-00717 64.61 609.02 562.73 70.00 70.00 Stock /Listed 280.0000 shares Windstream Corporation Total Stock /Listed Rea I Estate Real Estate - 220 Garrett Lane, East Pennsboro Township. Tax Parcel No. 09-19-1596 -016 recorded in Cumberland County Deed Book 14L, Page 566 and Deed Book 15W, Page 207 (see appraisal attached) Total Real Estate 1,376.36 3,172.40 3,172.40 280,000.00 280,000.00 (Attach additional sheets if necessary) Total Personal Property and Real Estate 284,548.76